Long-term results of anterior chamber iris claw intraocular lens implantation in children with ectopia lentis in Marfan syndrome

IF 16.4 1区化学 Q1 CHEMISTRY, MULTIDISCIPLINARY

Accounts of Chemical Research Pub Date : 2024-06-01 DOI:10.1016/j.jaapos.2024.103922

Elsbeth J.T. van Zeeburg MD, PhD , Marije L. Sminia MD, PhD , Professor Nicoline E. Schalij-Delfos MD, PhD

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Abstract

Purpose

To report the long-term clinical and endothelial cell count (ECC) results of lensectomy with primary anterior chamber iris claw lens implantation in the eyes of patients ≤18-year-old with ectopia lentis due to Marfan syndrome.

Methods

The medical records of Marfan patients operated on at a single institution from September 2007 to August 2020, with minimum follow-up of 2 years, were reviewed retrospectively. The following data were analyzed: sex, age at surgery, indication for surgery, the position of the lens in relation to the undilated and dilated pupil, corneal endothelial cell counts (ECC), peri- and postoperative complications, pre- and postoperative best-corrected visual acuity.

Results

A total of forty-two eyes of 23 patients (12 girls and 11 boys) were included. At least two or more postoperative ECCs were collected from 33 eyes (17 patients). Median age at IOL implantation was 6.1 years (range, 1.8-18). Median overall follow-up time was 6.2 years (range, 2-13.5). Median ECC follow-up time was 6.2 years (range, 2-10). Mean best-corrected visual acuity was 0.71 ± 0.38 logMAR before surgery and 0.02 ± 0.25 logMAR at final follow-up. The mean annual ECC decline was 0.71% ± 2.24. Total cell loss from first to last postoperative measurement was 150 cells ± 394 cells/mm² (4.81%). Pre- and first postoperative data were available for 17 eyes of 10 patients, with a mean cell loss before and directly after surgery of 269 ± 268 cells (7.94%). Surgery related complications were iris bombé due to blockage of peripheral iridectomy in 3 eyes and claw dislocation due to direct impact trauma in 3 eyes.

Conclusions

In our large, pediatric study cohort, anterior chamber iris claw IOL implantation resulted in an excellent visual outcome and normal endothelial cell loss compared with normative data. Safety measures are recommended to avoid traumatic dislocation of IOLs.

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前房虹膜爪型眼内透镜植入术在马凡氏综合征眼睑外翻患儿中的长期效果。

目的：报告18岁以下马凡综合征（Marfan Syndrome）眼球外翻患者接受晶状体切除术和原发性前房虹膜爪晶状体植入术的长期临床和内皮细胞计数（ECC）结果：方法：回顾性分析 2007 年 9 月至 2020 年 8 月在一家医疗机构接受手术的马凡氏综合征患者的病历，随访至少 2 年。分析了以下数据：性别、手术年龄、手术指征、晶状体与未散瞳和散瞳瞳孔的位置关系、角膜内皮细胞计数（ECC）、术前术后并发症、术前术后最佳矫正视力：共纳入 23 名患者（12 名女孩和 11 名男孩）的 42 只眼睛。从 33 只眼睛（17 名患者）中收集到至少两次或两次以上的术后 ECC。植入人工晶体时的中位年龄为 6.1 岁（1.8-18 岁不等）。总体随访时间中位数为 6.2 年（2-13.5 年不等）。ECC随访时间中位数为6.2年（2-10年不等）。手术前的平均最佳矫正视力为 0.71 ± 0.38 logMAR，最终随访时为 0.02 ± 0.25 logMAR。ECC年平均下降率为0.71% ± 2.24。从术后第一次测量到最后一次测量，细胞损失总数为 150 cells ± 394 cells/mm2 (4.81%)。10 名患者的 17 只眼睛获得了术前和术后第一次测量的数据，术前和术后细胞损失的平均值为 269 ± 268 个细胞（7.94%）。与手术相关的并发症有：3 只眼睛因虹膜周边切除术堵塞而导致虹膜炸裂，3 只眼睛因直接撞击创伤而导致虹膜爪脱位：在我们的大型儿科研究队列中，与标准数据相比，前房虹膜爪式人工晶体植入术的视觉效果极佳，内皮细胞损失正常。建议采取安全措施，避免人工晶体的外伤性脱位。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Accounts of Chemical Research 化学-化学综合

CiteScore

31.40

自引率

1.10%

发文量

312

审稿时长

2 months

期刊介绍： Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.